NPIMap

Organization Active NPI

The Bartell Drug Co

  • Community/Retail Pharmacy
  • Seattle, WA
National Provider Identifier
1548370232
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00055864 Issued in WA
Legal business name
THE BARTELL DRUG CO
Practice address
1407 Broadway
Seattle, WA 98122-3854
Phone
(206) 726-3495
Fax
(206) 726-3498
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peter Koo
Title
Sr VP of Pharmacy
Phone
(206) 763-2626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X CF00055864 WA Primary

Addresses

Primary practice location

1407 Broadway
Seattle, WA 98122-3854

Mailing address

4025 Delridge Way SW
Ste 400
Seattle, WA 98106-1249
Phone (206) 767-1316

Other identifiers 3

IdentifierTypeStateIssuer
6019749MedicaidWA
0333520048MedicaidWA
2110408OtherPK

Other names 1

  • BARTELL DRUGS #23 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000423 WA Part B Supplier - Pharmacy 2062305501 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

1407 Broadway
Seattle, WA 98122
Phone (206) 726-3495

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1548370232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 DELRIDGE WAY SW",
            "address_2": "STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981061249",
            "telephone_number": "206-767-1316",
            "fax_number": "206-767-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223854",
            "telephone_number": "206-726-3495",
            "fax_number": "206-726-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BARTELL DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "SR VP OF PHARMACY",
        "authorized_official_telephone_number": "206-763-2626"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00055864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019749",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333520048",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110408",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARTELL DRUGS #23",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.